Garden Banks Gas Pipeline, LLC
Original Volume No. 1
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Effective Date: 05/10/2010, Docket: RP10-594-000, Status: Effective
Third Revised Sheet No. 296A Third Revised Sheet No. 296A
Superseding: Second Revised Sheet No. 296A
EXHIBIT "B"
INTERACTIVE INTERNET WEBSITE ACCESS REQUEST FORM
Authorized Employee/Agent's Name: ________________________________________
Email Address _________@_________
Company (Employer):________________ Phone No.: _________
Facsimile No.: _________
Mailing
Address:______________________City:________________State:_________Zip:_______
Physical
Address:_____________________City:________________State:_________Zip:_______
SHIPPER COMPANY INFORMATION:
Complete Legal Name:_______________________________________________________
Mailing
Address:____________________City:________________State:_____Zip:_______
Physical
Address:___________________City:________________State:_____Zip:_______
DUNS No.:______________________ Federal Tax ID No.: ___________________
Indicate Update Capabilities for this Authorized Employee/Agent:
_____ Execute Contracts, Amendments and Accept Discounts
_____ Make Imbalance Elections/Trades
_____ Request New Service, Amendments and Discounts
_____ Receive and administer the payment of any and all invoices
_____ Submit Capacity Release Offers, Bids, Recall and Reput
_____ Submit Confirmations, PDAs, Storage Transfers
_____ Submit Nominations and Storage Transfers
_____ View only access to Interactive Internet Website screens, email,
web page and reports for SHIPPER will be available to SHIPPER'S
authorized employee
USER'S Signature:_________________________ Date: ____________________________
Officer of SHIPPER Company Signature: ____________________ Title:____________
Officer of SHIPPER Company Printed Name: ____________________ Date:__________
FOR INTERNAL USE ONLY
Garden Banks Gas Pipeline, LLC Officer Signature:_____________________
Date:__________
Title: ________________________________
Printed Name:_________________________
USER ID: ______________________________ Shipper# (if no DUNS) _______________
Security approved by:___________________ Date: _____________________________
PLEASE FAX COMPLETED FORM TO (832) 214-5791